Vaccines are rightly acknowledged as being among the most important public health breakthroughs in human history. But disease prevention has always had its skeptics in America. As far back as 1721, Dr. Zabdiel Boylston agreed to try smallpox inoculation, which had been used with some success in Africa, to protect the people of Boston when an epidemic swept the city. Despite his success in lowering death rates among the inoculated, Bolyston and his family were subjected to public vitriol and threats.
Today, the pattern continues, noted pediatric immunization experts during a recent webinar hosted by US News & World Report. Though scientists and researchers have developed effective vaccines to nearly eradicate diseases like measles and polio in many parts of the world – and to mitigate emerging global threats like COVID-19 – a strong and vocal camp of deniers continues to ban their efforts. Today, experts say, misinformation and outright disinformation are contributing to unnecessary illness and deaths by bolstering resistance to vaccines. And now this movement will lead to more children not being vaccinated, increasing their risk of serious contracting, but entirely preventable, diseases.
In Texas, for example, COVID-19 vaccines, though approved for infants and toddlers, are going largely unused, said Dr. Julie A. Boom, director of the Texas Children’s Hospital Immunization Project and a professor of pediatrics at Baylor College of Medicine. Though children have generally fared better during the pandemic, over 1,000 have nonetheless lost their lives nationwide because of COVID. “No child should die … every child’s death is an absolute tragedy, especially now that we have a vaccine,” she said.
In fact, COVID is now the No. 4 cause of death among children, behind accidents, cancer and suicides, said Dr. Sean O’Leary, a professor of pediatrics at the University of Colorado School of Medicine and Children’s Hospital Colorado, as well as chair of the Committee on Infectious Diseases for the American Academy of Pediatrics. “If we had a simple, safe, effective intervention to get rid of any one of those single things, we would jump at it.” With COVID-19, “we have that and, unfortunately, a lot of parents aren’t taking it,” he said.
Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, and professor of vaccinology and of pediatrics at the University of Pennsylvania’s school of medicine, said he was hopeful that, with upwards of 90% of the population either vaccinated or carrying some Natural immunity from infection, COVID will, in time, become more of a nuisance disease, like colds and the flu, for most people. That said, “I think moving forward, we’re going to need to protect the most vulnerable,” he cautioned, including the elderly, the immunocompromised and those with other conditions that increase the risk of serious disease.
Another consequence of the pandemic was that it closed pediatrician offices and interrupted normal vaccination schedules for many children across the country, panelists said, even for families seeking them. Though rates have returned to close to normal, “we have a whole new group of children that are delinquent” from their standard vaccines, Boom noted. The situation has been exacerbated by parents who have been convinced by the public attacks on COVID vaccines, to be equally leery of standard childhood vaccines. With more children left unprotected, Boom and the other panelists express concern that the US might experience localized outbreaks of measles and other diseases this fall and winter.
“The anti-vaccine movement has now sort of linked itself to the right,” Offit said, and the idea that mandates somehow interfere with one’s “bodily autonomy. You know, this ‘government off my back, don’t tell me what to do’” mindset.
“Vaccine mandates were born, in many ways, in the early 1970s, with measles outbreaks that occurred,” Offit said. “By implementing those mandates, you virtually eliminated, by the year 2000, the most contagious, or one of the most contagious, of the infectious diseases.” Offit expressed concern that the body autonomy movement might lead to a position of: “Don’t mandate any vaccine” with potentially catastrophic public health consequences.
Indeed, many state legislatures are crafting bills to do just that, the panelists warned. Previous anti-vaccine bills had failed, O’Leary noted, “so I’m encouraged by that. But I think we need to continue to educate our legislators on the importance of childhood vaccines.”
The panelists emphasize how critical it is for medical professionals and the community organizations they work with to keep engaging with the public to combat disinformation, “not only for our patients, but even in our personal circles,” Boom said. “People look to us for advice, and we have to remember that and stay out and stay vocal in our communities.” Part of that, she said, includes educating people on the financial motivations of anti-vaccine groups, many of whom are “sucking parents in” and “stuffing [their] pockets” by hawking health products and services of dubious value.
Offit said that community engagement is most effective at “the really local level.” For example, he mentioned a group, the Black Doctors COVID-19 Consortium, which went directly to a heavily African American community in North Philadelphia and vaccinated some 50,000 people. Their physician-leader, Dr. Ala Stanford, and her team took the approach of “sitting in their living rooms and doing the best [they] could to try and explain why it was important” to get vaccinated, Offit said. “I think it’s a model for how to do it. It has to be local, it has to be somebody people can identify with and trust,” he said. “That’s much harder to do, but I think it’s doable.”
Trust, indeed, is the primary concern for medical professionals in the face of anti-science and anti-vaccination propaganda. One challenge, O’Leary noted, is that in public health, “when we do our jobs really, really well, nothing happens. No one’s running up to me and giving me a hug because their child didn’t die of meningitis.” Nonetheless, the challenge, O’Leary and the other panelists suggested, is to not let the hard work of many decades be rolled back by the anti-vaccine forces, who’ve worked so hard to wrong faith in the public health community.
Rebuilding trust is essential, the panelists said, and it will likely take time. “It has been really heartbreaking to see some of the attacks that have been happening among people that are really just trying to make the world a better place,” O’Leary said. “There’s this huge segment of the population who has really lost trust in public health [experts]where really they are looking out for the best interests of everyone, no matter what your political views are.”